McKenna's Pharmacology for Nursing, 2e

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P A R T 1 1  Drugs acting on the gastrointestinal system

TABLE 57.1

DRUGS IN FOCUS Drugs used to treat gastro-oesophageal reflux disease and ulcer disease (continued)

Drug name

Dosage/route

Usual indications

Histamine-2 antagonists (continued) nizatidine (Nizac, Tazac)

150–300 mg PO at bedtime or 150 mg PO b.d., 75 mg PO 30 min before food to prevent heartburn; reduce dose in renal-impaired or geriatric people

Treatment of duodenal ulcer, benign gastric ulcer, pathological hypersecretory syndrome, GORD; relief of symptoms of heartburn, acid indigestion, sour stomach in adults Special considerations: Not recommended for use in children Treatment of duodenal ulcer, benign gastric ulcer, pathological hypersecretory syndrome, GORD; relief of symptoms of heartburn, acid indigestion, sour stomach in adults Special considerations: Not recommended for use in children Symptomatic relief of gastrointestinal (GI) hyperacidity; treatment of hyperphosphatemia; prevention of formation of phosphate urinary stones Symptomatic relief of GI hyperacidity, treatment of calcium deficiency, prevention of hypocalcaemia Symptomatic relief of GI hyperacidity; prophylaxis of stress ulcers; relief of constipation Symptomatic relief of GI hyperacidity, minimisation of uric acid crystalluria, adjunctive treatment in severe diarrhoea Treatment of GORD, severe erosive oesophagitis, duodenal ulcers and pathological hypersecretory conditions Treatment of gastric ulcer, GORD, pathological hypersecretory syndromes; maintenance therapy for healing duodenal ulcers and oesophagitis; in combination therapy for the eradication of Helicobacter pylori infection; approved for use in children for treatment of GORD, peptic ulcer and Zollinger–Ellison syndrome Treatment of gastric ulcers, GORD, pathological hypersecretory syndromes; maintenance therapy for healing duodenal ulcers and oesophagitis; in combination therapy for the eradication of H. pylori infection; available over the counter (OTC) for relief of heartburn symptoms Treatment of GORD in adults; healing of erosive oesophagitis, treatment of hypersecretory syndromes Treatment and maintenance of GORD; treatment of duodenal ulcers, pathological hypersecretory conditions; used as combination therapy for the eradication of H. pylori infection

ranitidine (Zantac)

150 mg daily to b.d. PO for heartburn; reduce dose in renal-impaired or geriatric people

Antacids aluminium hydroxide (AlternaGEL)

600–1200 mg q.i.d

calcium salts (Tums)

0.5–2 g PO as needed as an antacid

magnesium salts (Kruse’s Fluid Magnesia)

280–1500 mg PO q.i.d., dose based on salt used Paediatric: half of the adult dose Adult: 300–2000 mg PO daily to q.i.d.

sodium bicarbonate (generic)

Proton pump inhibitors esomeprazole (Nexium)

Acute: 20–40 mg/day PO for 4–8 weeks; 20–40 mg/day PO for maintenance

lansoprazole (Zopral, Zoton)

15–30 mg/day PO based on condition and response; 30 mg IV over 30 minutes for up to 7 days Pediatric: 1–11 years (≤30 kg): 15 mg/kg per day PO 1–11 years (>30 kg): 30 mg/kg per day PO 12–17 years: 15–30 mg/day PO

20–40 mg/day PO for 4–8 weeks based on condition and response

omeprazole (Losec)

pantoprazole (Gastenz, Ozpan)

40 mg PO daily to b.d. or 40 mg/day IV for 7–14 days

rabeprazole (Pariet, Prabez)

20–60 mg/day PO based on condition and response